Project Summary/Abstract Despite a high prevalence of HIV among gender minority women, very little is known about HIV comorbid conditions in this population. Understanding the mechanisms of underlying HIV-related comorbidities in this health disparity population is an important step toward advancing health equity. The address this gap in knowledge, the study seeks to elucidate pathways linking stigma and physiologic stress to HIV comorbidities among Black and Latina gender minority women. The specific aims of the project include to: (1) quantify the longitudinal relationship of stigma to chronic stress biomarkers; (2) identify pathways linking chronic stress biomarkers to HIV comorbidities; and (3) examine the role of chronic stress in pathways linking stigma, sex hormones, and HIV comorbidities. These aims will be met using existing NIH-funded cohort platforms to enroll and follow 200 participants in a 24-month, mixed-methods, prospective study to measure stigma, biomarkers of chronic stress, sex hormones, mental health, and CVD risk. Data will be collected at baseline, 6-, 12-, 18-, and 24-months. This longitudinal study blends in-depth-interviews and quantitative psychosocial research with clinical and biological measures to advance understanding of the complex relationships between social experiences and physical health. This innovative research will identify mechanisms underlying associations between stigma and HIV comorbidities. It has important implications for interventions with health disparity populations living with HIV and will provide novel information that can be used to guide clinical practice and reduce health disparities.